Physicians Practice has been asking physicians and practice administrators about their use of technology for over a decade. Now, many practices are on a second or third EHR system, and an increasing number use a cloud-storage solution for patient data.

Technology expert Derek Kosiorek, a consultant with the Medical Group Management Association, says "We see, especially [in] the healthcare sector, certain timeframes when there is a wave of technology adoption. … The big upgrade [for practices] was moving to the EHR." Chances are, your practice is somewhere in the process of implementing a new EHR, upgrading old systems, or adding new technology like a patient portal. If you are wondering where your peers are on the EHR adoption continuum, here's what we found out.

Data systems

Hands down, EHRs are the largest piece of technology that medical practices purchase. Whether your practice is part of a large integrated delivery system or a small independent "shop," EHR is the scaffolding that supports all other technology use. According to our 2014 Technology Survey, Sponsored by Kareo, which asked over 1,400 physicians and practice administrators how they are using technology in their practices, 53 percent of respondents say they have a "fully implemented EHR," and another 17 percent use a system provided by a hospital or corporate parent. Only 20 percent of respondents say they do not currently have an EHR. When compared to past years, the trend is a slow but steady adoption of EHR: In 2010 (the year meaningful use became effective) 48 percent of responding practices had implemented an EHR, in 2014 that number was 70 percent.

John Squire, president and chief operating officer of Amazing Charts, says his EHR company, which caters to small primary-care practices (one to five docs), sees similar adoption patterns. Approximately "half of the practices we contact are coming from paper. We get about 30 percent of our business from 'switchers,' somebody who has adopted another EHR system or is getting off of it," says Squire. He notes that many non-adopters are finally deciding to purchase technology, a concept he calls "the last mile," because their attitudes on technology are changing and with the extended deadline for meeting meaningful-use targets, physicians can still take advantage of the financial incentives.

Even if practices decide to opt out of government programs like meaningful use, an EHR can support many practice operations like keeping clinical records and generating patient billing statements. Squire says his company also sees an increase in interest in patient portals for similar reasons. For those practices that are preparing to attest to the Stage 2 rules of meaningful use, it is a necessity to have a portal, but for those that don't the benefits to patients and practice alike are still very real — for instance, removing the burden of "call-backs" to answer routine patient questions.

Patient portals also give a competitive advantage to your practice. Kosiorek notes that patients have come to expect online access to services like banking. He predicts that, soon, practices won't really have a choice. "I think it is going to be a competition thing. Your competition down the street across town has that portal, so any patients are going to start migrating toward that, especially newer patients," he says.

According to our survey, attitudes about the challenges of technology adoption are also shifting. Three years ago, our survey indicated that "cost" was the primary concern for technology adopters. This year, that has changed: EHR adoption and implementation concerns came in first and cost slipped to third place. That dynamic is slightly different if the numbers are sorted by independent and hospital-owned practices. But not as much as one might think: Adoption and implementation of EHR is the primary concern for both groups, with interoperability and cost in a near tie for second place for independent physicians. For hospital-owned practices cost is much less of a worry.

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